00:01 A client has been taking oxycodone for pain for several weeks. 00:05 Which sign indicates to the nurse that the client might have developed a tolerance to the drug. 00:11 Okay, so, we know they've been on oxycodone, that's a drug we're talking about. Right? So what type of med is that? It's an opioid for pain. That makes sense. 00:21 They've been on it for a while. 00:23 So which sign indicates the nurse that the client might have developed tolerance? What does that mean? Well, when the body builds up a tolerance, the same dosage doesn't have the same level of effectiveness for them anymore. 00:37 So, now, let's look at the answer choices. 00:40 There we go. Just four, right? This is just one of the answer. We're not a select all that apply. 00:46 This is just what is the most correct answer. 00:49 Please write down 1, 2, 3, 4. 00:52 Pause the video. 00:53 Walk through each of these answer choices, eliminate instead of gravitating and say why on each question, then start the video again, and we'll walk through it together. 01:12 So I'm looking for something that indicates tolerance. 01:14 So, would number one indicate tolerance? The medication is just as effective as it was at the beginning. 01:23 Nope. Because the work we did and the topic of the question, we know that tolerance means it's not as effective. 01:29 So number one is out. 01:31 Number two, the client no longer gets constipated when taking oxycodone. 01:37 Now, that's a whole another issue. That isn't tolerance. 01:39 So, no. In fact, really, tolerance to constipation doesn't really occur. 01:44 If a patient has a problem with opioids, that problem lingers, unfortunately. 01:50 So one and two, they're out. 01:52 Number three. 01:53 The client has withdrawal symptoms when stopping the medication. 01:58 Is that tolerance? No. 02:01 That means, they didn't wean the medication. 02:04 And because they've been on it for several weeks. 02:06 Wow. That's why they had withdrawal symptoms. 02:09 So it's so important in a CNS medication, like a pain medication and opioid that you work with the healthcare provider to slowly wean. 02:18 Gradually take smaller and smaller doses, with longer periods of time in between those doses, so the body can adjust to the change. 02:27 So we've eliminated 1, 2, 3. 02:29 I hope in four works. 02:31 The client asked for the medication more often. 02:34 That means tolerances build up. 02:37 Before when they started the medication, maybe the patient could go every six to eight hours, and they had enough relief and pain control. 02:44 But now, they're starting to really feel that pain revved up before that six to eight hours. 02:51 That's why they're asking for it more often. 02:53 That would be an indication that the patient has built up a tolerance. 02:57 Now we have an opioid crisis in the United States. 03:00 They were over prescribed for a period of time in our history, but they have a place in healthcare. 03:07 So don't assume that someone who's requesting treatment for pain is just seeking drugs. 03:14 Sometimes health care providers have a real bias against that. 03:17 Remember, pain in practice. 03:20 And in NCLEX is what the patient reported to be. 03:25 If you sense there's some type of problem or other issue going on, maybe you sense there could be an underlying addiction issue that is outside of the scope of a nurse, right. 03:36 That's outside of our scope of practice. 03:38 So you need to make the appropriate referral with the healthcare provider to get the patient the help they need and deserve. 03:45 Okay, good job. 03:46 Now you're ready for the next question.
The lecture Walkthrough: Pharmacological and Parenteral Therapies Q4 – NCLEX-RN® by Prof. Lawes is from the course NCLEX-RN® Question Walkthrough: Pharmacological and Parenteral Therapies.
Which is the most effective method for answering multiple-choice questions?
Which is the best way to assess a conscious client’s pain?
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